Sleep Training: A Review of Research

The following is a list of resources (articles/websites/books) for research-based information on infant sleep, night time parenting, baby crying, need for nourishment and comfort at night, and physiological body and brain responses to 'controlled crying,' 'cry it out,' or 'sleep training' methods. Also see psychological conditioning studies on the brain, immune system, development and learned helplessness (which occurs among babies whose care-givers utilize these methods).

"Crying-it-out does not lead to 'sleeping through the night' - it results in learned helplessness."-Danelle Frisbie

72 comments:

With all the stress of "Controlled Crying" causes the infant, I wonder... Their cortisone (stress hormone) must be off the charts! That cannot be good for a growing brain. Read an article about the "love hormone" reducing the likelihood of autism and thought the opposite, "stress hormones" increasing the odds of autism... hmmmm...

Cool list. With all the controversy around cry it out interventions, I really do wonder about the developmental implications for the child and the emotional trauma for the mothers. When I have some time I would also love to read feminist perspectives on the effect of sleep training on a mother's perception of her competencies. I'm sure there are many interesting papers to be read.

Zenbuoyant, I wondered the same thing recently. When did "cry it out" start becoming more common in the US? It seems like it's been in the last 40-60 years. Is there a correlation, at least, to the raise in autism?

I'd love to hear of any articles or studies on that subject, if you know of any!

There IS a correlation. An obvious relation. There is also a link between crying-it-out to fatal depression, various anxiety disorders, bipolar disorder and so on and so forth. Yes, many of these disorders have a genetic component, but in most cases those genes will never be switched on unless there is early childhood trauma, such as experiencing ab.andonment repeatedly. Time passes slower when you are younger, and what feels like an hour to an adult may feel like hours to a child, and hours may feel like days. Dr. John B. Watson was the first to come up with the "cry-it-out" cult. Other, even lesser "prophets" followed in his footsteps, despite Watson's theories never having been proven. They led millions of the gullible and illogical astray. Lazy types who can't be bothered to do their own research, but prefer to blindly trust another for the welfare of their child, as well as people with self-esteem problems who think they are not intellectually capable of reading research papers, though anyone with an IQ around 95 should be able to read them, at least with the help of a good dictionary. Watson's own children and grandchildren were raised according to his beliefs. Most of them only became insane. Some of them committed suicide. His and his wife's family were both "normal", with no history of such disorders. Watson came to his conclusion doing psychological experiments on an infant known as the famous "Baby Albert" case, which was damaging psychological terrorism experiment, done despite the odds of it being detrimental to the poor child's well fare. His interpretation of his findings were illogical and they are given no credence by any real psychologist or properly informed counselor. To follow his theories, or theories inspired by him, is no more scientific and logical than the belief in a flat earth or the earth being the center of the solar-system. It is outdated and there is simply no excuse for it. A moral person is not capable of committing experiments like the one Dr. Watson conducted on. There is only a difference in degree, but not in kind, in whether you put your trust in Dr. Watson and his various disciples or Dr. Mengele. It is a crime towards your own children and an insult to your own intelligence.

Thank you for this great list of articles. It only seems natural that families would sleep together. I am glad that there are scientific studies and sleep research being done to support what mothers do and feel intuitively.

No way, not happening in this house lol, never has. I rock my 1 year old to sleep and have a good schedule for that. I layed down with my other two til they fell asleep and did that til they started school and that worked too. I just can't see how having your child cry themselves to sleep every night is healthy. Parents are suppose to nurture their children. That's my opinion.

My little boy is 2, and while its been hard to deal with his sleep issues, I would much rather have sore arms, a sore back and a headache from putting him to sleep in a calm, nurturing way than allowing him to scream until he falls asleep through exhaustion. There's the 4 month old now =)

leaving them to sleep alone..is sort of a form of abandonment..I never did it..I'm 12 weeks now and wont be leaving mine to cry it out EVER..it just instills fear and why am I not being listened to..which makes for a child with rejection issues

There are hundreds of ways to be well rested, and to help your child be well rested as well, without putting them into the dangerous position that CIO puts them in, developmentally. The negative effects of excess cortisol on brain development are far reaching and, just because they may not be noticeable immediately does not mean that there was no harm done.

ive never had to wry about this, we still co-sleep with my 32 month old and breastfeed. she has always been an amazing sleeper and from just a few wks old would sleep throughout the whole night, and would just naturally latch on without actually fully waking up! i dont think i would ever have the heart to listen to her cry....in my opinion it just "feels" wrong to try to have a wee little one deal with their own emotions and crying. i immediately comfort my little girl over any situation and i have a daughter who feels secure and who is extremely well behaved....but thats just my opinion, every mother and child relationship is different! ♥

What does "self soothe" mean for a baby? they are left alone and have to deal with not being responded to when their only form of communication (crying) is failing them. at the very least they learn they are alone and they learn their resources (crying/communication) aren't serving them.

When my first was brand new, I thought that CIO was crucial, and that soothing, rocking, and bed-sharing were damaging to his character as well as his physical development. By two weeks, this exhausted mommy (who was recovering from a c-section) said, "to he'll with it!" I brought him to bed with me and never looked back.

That's when I started more peaceful parenting practices. My second was home-born, and has never slept anywhere but at my breast. We now sleep 2 adults, 2 kids, a dog, and a cat in a double--yes, DOUBLE--bed. Although my toddler has recently spent some nights on a mattress on the floor beside our bed. These days pass SO quickly! I don't want to lose a moment. Plus, I like getting a full night of mostly uninterrupted sleep. :)

Your baby spent 9 months cradled in your womb safe and sound. The way I see it, when you give birth to that child.. putting him or her in a crib to just "cry it out" until they finally fall asleep with exhaustion is NOT healthy. I'm glad I'm not the only one who sees it this way.

When I just THINK about letting my little girl lay in her crib to only cry herself to sleep it breaks my heart. All babies/little children want that closeness. They want to be held, they want to feel your arms around them because that's what makes them feel safe.

I hate sleeping alone and when my husband is deployed I will get her out of her bed and just cuddle with her. It makes me feel good as well as her. And waking up to her opening her eyes looking back at me and the first thing she does is smile a big smile... ahhhh, the love I feel. Ok... I'm done lol.

My husband is presently lying down with our 8 year old as I type, one handed because I'm holding our 6 month old baby. He also rocked our 27 month old to sleep and read to our 5 year old until he slept. It's fine. We like them.

They grow up so fast, and you look back and wish you had more time to hold and sing to them, rock them, cuddle them, and just love them. I couldn't help but just hold my babies and stare at them in amazement and love - and smell their heads, kiss their little cheeks, look at their tiny fingers and toes.... life is just too short to spend it being angry at these little wonders, and it's too short for them to spend it crying and feeling alone. You don't know how long you will get with them, so enjoy it while you can. Hold them, love them, kiss them, smell them, smile at them, sing to them, dance with them.... and be very very happy that you are lucky enough to have them.

I have 3 children and 2 are babies in diapers ( 10 months apart)... They have all co-slept an will until they are ready. My older daughter went to her room at 4, on her own. We have our 1 and 2 year old with us all night our arms and it's wonderful. It's sad the reasons people "justify" using the CIO technique... They don't want to be up all night, don't want to be kicked, don't want to "not be able to get rid of them" later.... It's unreal.

I know there are different types of cries and my daughter does some of them.

I love to co-sleep and do it all the time and have done it from the day she came home from the hospital. Sometimes she wakes up and starts crying so I go in, lay her back down and pat her bottom until she goes back to sleep. If after 3 tries this doesn't work, she goes STRAIGHT to bed with me.

I just can't stand to hear a few people I know state how they put their kid to sleep... lay them in their bed, shut the door and walk away. I can't do that. I don't know many people with a heart that could.

What's wrong with comfort? Even if a school-aged child sleeps with their parents, they are obviously going to grow out of it before college, LOL. So, what's wrong with it? They aren't going to be little for long- might as well enjoy it while it lasts.

Our son co slept and nursed through the night until he was 14 months and we laid down with him to sleep until he was..well, he's 4 now and sometimes we still do:) But we love it. Sometimes he sleeps with us just because it's fun:) Our daughter however wants to be in her crib (which makes me sad) and wants to sleep alone! So strange. SOmeone else said it, different kids need different things but I could never leave an infant to CIO. HORRIBLE.

I find it hard to comprehend why someone would post in favor of CIO on the Peaceful Parenting Facebook page. Perhaps there is some confusion as to what peaceful parenting means? Research does not support CIO. But research does show that bedsharing does not psychologically damage children. Indeed, much of the world does without a second thought. Humans are carry mammals, not cache mammals. Our young are meant to be close to us at all times.

We never let any of our 4 babies CIO and coslept with all too. As for studies about after-effects of CIO and not, the studies actually show the benefits in MANY areas are for the babies who are not left to CIO. Here's some: http://www.examiner.com/examiner/x-23788-Mankato-Attachment-Parenting-Examiner~y2009m12d29-Attachment-Parenting-101-Ten-reasons-crying-it-out-is-bad-for-babies

Crying is a form of communication. I have 4 children and not one so far has ever cried because they were happy, felt safe or wanted to take my time. The have all cried because of a need. I don't agree with CIO, ever. Just because the night falls doesn't mean it is ok to not be a parent.

My oldest sleep in a crib in my room for a period of time, then in her own room; never a tear. My 2nd sleep in our room much longer, then in her own room and bed when she was ready and ask but returned to our room often until 2 years ago; she's 10. Our 3 year old sleeps in her own room and my husband lays with her until she falls asleep or is comfortable being alone. She comes to our bed at times. Our 15 month old has a crib next to my side of the bed but spends most of her night between mom and dad.

There should not be fear or tears at bedtime. Children should be comforted to sleep!!

So many sleep books claim to be gentle, but really say nothing but some form of "controlled crying". We feel that our babies need to learn we are there when they need us, not "you're on your own to learn to go to sleep". We go with Dr. Sears philosophy of helping them learn that "sleep is a happy state to enter and a pleasant state to remain." Still having trouble with our 1 yr old, but our 3 1/2 yr old finally learned when he was about 1 1/2 - 2 yrs old that sleep is good.

Go dr sears- his book was a revelation to me when he said it's not our job as a parent to teach independence, but to be our child's security. What I've seen in my own environment, is kids that were forced to sleep on their own (non- babywearing) tend to be clingy when they are older, because they didn't have that security, and my own daughters who had every need met have come into their own independence as they were ready.

I'm so glad that I never gave in to letting my baby cry out of "convenience", even with all the old-school advice we kept getting (parenting isn't supposed to be "convenient" - I love what one poster wrote about the fact that just because night falls doesn't mean parenting stops! :) - he's now at an age where he understands we will meet his needs consistently, and that we are right across the hall if he needs us. It's wonderful to know his little mind is working that way, and that by not letting him CIO, we instilled his very first lessons of sensitivity and empathy. I would not trade a moment of rocking him to sleep or snuggling next to him for anything - he's already on the go so much during the day that nighttimes have become our "reconnection" times, as well! :)

I'm also happy we understand what is normal about infant development, so we could work through our frustrating moments with more patience. Babies' brains need to be alert even in sleep during the early months to develop, and waking establishes a biorhythm with mom as a primitive survival instinct - perhaps if our society would embrace these patterns as the normalcy they are, then parents wouldn't be so quick to turn to books when they believe their babies are "abnormal", or to solve problems that aren't really problems at all. We are seeing generation after generation of disconnected kids stemming from early detachment because parents turned to those "manuals" and didn't get to know their children though reading their cues; at the time, no one was aware of the long-term consequences. We know better now, and we have to do better for our children!

As adults, we don't expect to sleep alone! And we expect comfort and support if *we* are upset and crying about something, too. We can't pick and choose the moments our kids need us, and we can't dismiss their needs as "inconsequential" (how do *we* know it's not a valid need? Sometimes babies just need to be held, bottom line). By showing them sensitivity early on, and keeping them close, they will turn into trusting, independent children and adults, with a wonderful sense of empathy for others, and confidence in their own decision-making abilities because they themselves were nurtured.

Crystal - I love that part about not teaching independence, but giving security. That's exactly right! Independence comes from being securely attached in the early years, even though the benefits are not readily apparent - something some people don't have the patience for, to the detriment of their children. In our society, we want what we want when we want it, and we expect our babies to just adapt to us, instead of the other way around. I've seen firsthand how forcing my first son into independence too early has negatively impacted him 7 years later, with oversensitivity, and a lack of self-confidence in his decision making, because he was unprepared to enter each stage of development - thank goodness for Dr. Sears, and having another child (which I parented so differently and am now seeing such a difference in our relationship) so I can work on those things with my older one! :)

It's funny how we have lost faith in our children. I know I'm fortunate to have grown up in a family where things like CIO were condemned. I learned a lot about how children act and grow when their needs are met without manipulation or conditioning.

So I guess it's just easier for me to have faith through the few hard nights and know that I am raising a person right here, right now, not a creature that needs to be molded into a person at some later age.

DD has never been forced in any sleeping routine or method, nor has she been left alone or to CIO.

Thanks to my family experience, I expressed no surprise when she began laying down in the family bed and falling asleep all by herself. Although I do have that bittersweet mama twinge in my heart to see her growing up!

It's so sad to think of the way little people are treated simply to drive results that happen on their own anyways. Every child eventually stops nursing, stops rocking, stops cuddling and grows up...Cherish and love them while they are little. ♥

I stumbled upon your blog from a link posted by a local retailer. I have read and re-read so many articles, my eyes are red! :)Parenting my little ones has been a challenge. I am often called a "hippie" or "unconventional" for my belief in breastfeeding, baby-wearing, co-sleeping and having my sons intact. Feeling alone for many years with so many people on my case about how I am raising my children had left me bitter, until I got to this blog! It is refreshing and so helpful to find women out there like me! I just want to say thanks!!!! I have a renewed sense and am proud of being an "attatchment" parent!

I have to admit that some nights, I sneak out to my DD's little bed if they are all peaceful with daddy.. but other than that, I have been sleeping with increasing amounts of children in my bed for over 5 years! Change your thoughts, change your mind...

There is nothing more satisfying to waking up to what we call our family pretzel, though - me and dh, ds (4), dd (almost 3) and the bb(almost 2) and yes, in a single bed! <3

When woeking at the Newman clinic, it is one of my bigggest joys to say "yes, you absolutely can bed-share! and here's how to make it safe.... so you can get more sleep and be with your baby". Most moms just need permission since they get such confrontation about it from others.

I find it amazing that parents and caregivers look for so many remedies for baby to sleep better without considering massage. Why? I sleep much deeper, sounder and much better after a massage don't you? I just completed a critical review for my PhD prelminary exam on the many benefits of Infant Massage. IM is so powerful that even mothers who reported depression symptoms and "watched" their babies' being massaged reported less symptoms afterwards, after fathers massaged their babies' the babies initiated engagement behaviors such as eye contact and verbal sounds to get their father's attention, volunteers who massaged babies reported more life satisfaction....see massaging babies is the gift that keeps on giving....good for baby and the person providing massage. Maybe, just maybe we could withdraw from the world long enough to massage a baby to sleep?

This is quite an extensive list..I will have to check these out when I have time. I never realized "CIO" was such an issue, especially in early infancy. I have 2 sons and now an infant daughter...All three were kept in my bedroom next to the bed in a crib until at least 6 months, and I slept and napped with them in my bed at every opportunity. co-sleeping helps with night-time nursing as well. I never imagined a parent would let a very small baby cry themselves to sleep...young babies need the most attention, care and stimulation for healthy development. Cuddling, sleeping with, nursing/feeding anytime they are hungry, and even just speaking to and touching your baby to soothe them can only promote healthy normal development... not spoil the child. Unless my child is old enough for "fake" crying and temper-tantrums, I at least check on them at any sound they make. If my baby cries, it needs something...food, drink, a more comfortable temperature, a clean diaper, a change in position, to be spoken to or held, or just a soft touch and to know Mama is there and they are safe. My one-month-old little girl Rose gets fretful if she does not get some close one-on-one cuddle time with both myself and her daddy each day, and just adores having her big brothers close.

I have never been able to understand how someone could make a baby cry themselves to sleep. I never could. We slept with our oldest until he was 2, when his sister was born, then DH slept with him and I slept with the new baby. Now, at 7, DS usually sleeps in his own bed and DD (5) usually sleeps in hers, while DD (18 months) sleeps with us. I can't imagine doing it any other way. I helps with breastfeeding, as well.

That first picture is really disturbing. Absolutely everything about it is wrong! Bumpers, a puppy pad (which means there is a PLASTIC liner), loose blankets, monitor with cord attached IN the crib... oh and the crying baby!

I have a friend who lets her son "Cry it Out" and I have NEVER in my life known of a child who is soooo detatched emotionally. He does not like to be cuddled, kissed, rocked, loved on, hugged etc. He seems extremely behind developmentally and doesn't say much at all. She also did the CIO method with her daughter and she is very whiney, needy, demanding, emotional, COMPLETELY dependent, and insecure. It seems as if it is easier on the mom but there is something about the children being sooooo detatched from affection... :(

I have seen similar effects, its exactly wehat i would expect - if you teach your baby no will do anything when you cry, no one will comfort you if you need someone, can you really expect them to ha capacity for empathy/sympathy to anyone else as they grow up? Is absoluty heartbreaking, sad and scary to see what kind of people are being made out of these methods.

I was also very disapointed to see an episode of 'Heartland', on cbc - a show that is generally positive and promotes respect and positivity relating to animals and people. The episode was of the older sister whos baby was having sleep problems - so they decided to do the crying it out method - was so disapointed to see that on a tv show that i had generally liked, and wondering how many mothers/parents were influenced by seeing it.

Whenever I go to the doctor to try and find why my son refuses to sleep at night, and wakes up so much for no reason, all they say is 'cry it out' no wonder I am getting physically ill from not getting enough sleep and my sons development is a little behind from also being restless some days. I refuse to take CIO for an answer to all our problems. This is why US is so overruled with CIO, because doctors left and right say that without any compassion. You have to tell them 'we've done it and doesn't work' so they actually start considering a real issue, and sometimes they even think it's just autism because a child doesn't sleep. It's horrible.

Just have to say my son never ever cried it out. And he is autistic. I don't believe autism can be simplified to one cause or blamed on a parenting style. My son is 4 and is welcome into our bed as he needs. He slept with us from day one. We always attended to his cries.

Any suggestions, resources or thoughts on napping? We co-sleep with our 7 month old, and have from day one, but he is a TERRIBLE napper! He really only naps when I am home with him and nurse him to sleep, and then nurse him BACK to sleep after his typical 30 minute cat-nap. For some reason, he almost always wakes up after 30-35 minutes, and will often go back to sleep if I lay down and nurse him (when he does go back to sleep, he takes a 2-3 hour nap). Unfortunately, this only works for us if I'm home, which means only for the morning nap, and only certain days of the week. I work two part time jobs, and I'm fortunate to have one very flexible employer who allows me to bring him to work with me, and to stay home in the mornings every day but Thursday. But I also work as a nurse, 4 12 hour shifts then 10 days off. When I work away from him, he will sometimes sleep well for my dad, but most of the time it's a 30 minute nap every 2 hours instead of 1 or 2 good naps in a day. When I take him to the office with me, I have a lot of difficulty getting him down since I can't lay down with him. I nurse him to sleep, but he wakes after 30 min in the play pen. I've tried wearing him, but again, he'll only sleep for 30 minutes and he gets WAY too hot. Both at home and at the office I've tried total darkness, white noise, pacifier, no pacifier, music, laying him down sleepy (HA!), and everything else we can think of. Sorry to have rambled, I just feel so bad for him when he doesn't get the sleep he needs during the day. We all pay for it. :)

I just submitted my first graduate level paper on infant sleep, I hope I did the subject justice...I have read everything there is to read and the results are definitive. Hold your babies close as much as you can and sleep together safely. I deeply regret the sleep training I did with my own two now-grown children, and see the long-term effects in them still.

Thank you for this list! I have been feeling bad lately for not sleep training my 13 month old. I am glad to know I am not a bad mom for doing something I dont feel comfortable with. I have been scolded for co-sleeping, not sleep training and still nursing my 13 month old.

I had to deal with this issue in my own family. I didn't understand how my sister could do it, my niece would sometimea scream for hours, and I was constantly condemned for sleeping in the bed with my son. He is now 3 years old and wants to sleep in his own bed so he does. There were a few stressful times when they would cry and I'd have to put them down and walk away, but never at the time for them to sleep. I may very well be clingy, but they won't be babies forever and I want to show them I love them any way I can, especially since I work 50 to 60 hours a week.

My son is almost 6 and he still co-sleeps with me. I co-slept till I was 10. Right now, he is sound asleep beside me.

He does have sleep issues and is on Remeron. As a newborn he might have only slept 9 hours a day (24 hour period). There are times now that he might be awake for 28 hours with maybe a 30 to 45 min nap. He was prob 3 before he slept through the night (midnight till 7am). Even now, he goes to sleep around 2 and wakes no later than 10. When he was put on Elavil for migraines he was back to the 24+ hours awake, sometimes straight through. THen sleep 2 hours and up again for 12+ hours - sometimes he was up for 36 hours or more with 2 hours sleep! Let's just say that I was going crazy. After 3 weeks of this, med was changed to Depakote. Not much better with that either.

Now we are back to Remeron only, but headaches/migraines have started again.